Fundamental Critical Care Support Course
$375.00
In Person Attendee
Available: 30
(If so, you must register with your Memorial Hermann E-mail address)
Registration Information
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Emergency Contact Name
Emergency Contact Number
Select your discipline (click all that apply)
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APP-Nurse Practitioner
Nurse
APP-PA
EMS / Paramedic
MD
Other
Discipline - Other
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Date of Birth (MM/DD)
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Date of Birth (MM/DD)
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Date of Birth (MM/DD)
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Professional License Number (as it will appear on course certificate)
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Professional License Number (as it will appear on course certificate)
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NABP#
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Date of Birth (MM/DD)
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Degree (as it will appear on course certificate)
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ASHA number (as it will appear on course certificate)
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Professional License number
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Do you want to receive ASHA CEUs?
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Yes
No
Professional License Number (as it will appear on course certificate)
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Professional License Number (as it will appear on course certificate)
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Employer Location
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Special Dietary needs
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None
Vegetarian
What type of book would you like?
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Text book
E-book
I am registering for the APP Cadaver Skills Training Lab. (A promo code will be emailed to you. Do not register for cadaver lab until you have received the code).
Yes
Please comment if you require any assistance, needs or accommodations:
In consideration for the opportunity to participate in this event, I agree to RELEASE, DISCHARGE AND AQUIT FOREVER the Memorial Hermann Health System, its subsidiaries, its respective officers, directors, agents, members, and employees from any and all liabilities, claims, causes of action, costs and expenses (including, but not limited to, court costs, penalties, attorneys' fees and disbursements, and amounts paid in settlement) of any kind or character whatsoever, arising out of or relating to my participation. This release includes, but is not limited to, all claims under any state, federal, or local law or regulation and all claims at common law, including without limitation negligence and tort claims, and all claims for damages, exemplary and punitive damages, costs, and attorneys' fees.
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I Agree
Please Acknowledge:
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I have read and understand the education credits and attendance needs for my profession as stated in the education materials.
Cancellation Policy:
1. Cancellation of the continuing education or competency event by Memorial Hermann Health System, or as a result of a 3rd party cancellation, will result in a full refund of registration monies received. Memorial Hermann Health System is not responsible for the refund of travel or hotel expenses. Memorial Hermann reserves the right to cancel or change any programs for due cause. In the event of a course cancellation, participants will be notified via email and contact phone number listed on the registration form.
2. The primary cancellation policy by an attendee for a continuing education or competency event must be provided in writing a minimum of 14 calendar days before the course start date in order to receive a refund. Refunds, less a 25% administrative charge will be given if notice is received within the stated timeframe. Registration fees will not be refunded for cancellations less than 14 calendar days before a course.
An email should be sent to
LifeFlight.education@memorialhermann.org
.
Cancellation Policy:
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I have read and understand the cancellation policy as stated in the course materials.
Do you allow Memorial Hermann to share this specific information with associated course instructor and/or associated group affiliated with this course or conference.
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Yes
No
Receive email communications, including marketing communications, from Memorial Hermann Health System via email or text. (Text charges may apply.)
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How did you hear about this course? You may select more than one answer.
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